Scoliosis and spine care

Scoliosis and spine care

From common idiopathic adolescent scoliosis to the most complex young spine deformities, we believe each child deserves an individualized treatment plan using the most advanced and innovative techniques.

Conditions treated:

Idiopathic scoliosis, including infantile, juvenile and adolescent

Congenital scoliosis

Scoliosis with syndromes including:

VACTERL

Marfan

Neurofibromatosis

Klippel-Feil syndrome

Torticollis

Neuromuscular scoliosis associated with:

Spinal cord injury

Cerebral palsy

Kyphosis, including Scheuermann's

Spondylosis and spondylolisthesis

Curve progression after spine surgery

Abnormal posture

Hemivertebrae with fused or absent ribs

Scoliosis after thoracotomy

Types of scoliosis:

Infantile idiopathic scoliosis – occurs in children younger than age 3

Juvenile idiopathic scoliosis – affects children between the ages of 3 and 10

Idiopathic scoliosis – generally occurs in children after the age of 10; girls have a greater likelihood to develop idiopathic scoliosis

Signs of scoliosis

Scoliosis can be hereditary, and it is recommended that a child who has a parent or sibling diagnosed with idiopathic scoliosis receive regular check-ups for early detection. Children and teens with scoliosis rarely exhibit symptoms, and sometimes the condition is not obvious until the curvature of the spine becomes severe. Sometimes you may notice that your child’s clothes are not fitting correctly or that hems are not hanging evenly. In some cases, your child’s spine may appear crooked or their ribs may protrude. Some markers to watch for in a child who has scoliosis are:

One shoulder may appear higher than the other

One shoulder blade may stick out farther than the other

One hip may appear higher than the other

Head is not properly centered over their body

When bending from the waist, the ribs on one side are higher

Waistline may appear flat on one side

Nonsurgical treatment options

Bracing

Nonoperative treatment for idiopathic scoliosis:

Can be effective in stopping the progression of the curve

Schedule and type of brace will depend on the location and degree of curve

Compliance with wearing the brace is vital to the success of bracing treatment

Mehta casting

For infantile scoliosis when the curve is progressive:

Requires cast changes under anesthesia every two to three months

Casting straightens the spine through the continuous application of external force

Casting, if started at a young age, can make the curve disappear in some children.

Growing systems

Expandable devices used in growing children with scoliosis:

Vertical expandable prosthetic titanium rib (VEPTR or titanium rib) – This is a titanium rod curved to fit the back of the chest and spine, and is designed to primarily be used for growing children with a chest wall deformity and thoracic insufficiency, helping to correct spinal deformity and allow for the development of the chest and lungs.

Growing rods – Growing rods allow for continued and controlled spine growth. This is performed as a surgical procedure through the back where the rods are attached to the spine both above and below the curves with screws. The growing rods will need to be lengthened under anesthesia every four to six months, depending on the advancement of the curvature of the spine.

MAGnetic expansion control (MAGEC) spinal bracing and distraction system – MAGEC rods are another form of growing spine construct for young children. With MAGEC rods, a surgical procedure for implantation is required, but the noninvasive lengthening procedure eliminates the need for repeated lengthening surgeries. The MAGEC System is composed of two magnetic, telescoping rods that can be gradually lengthened from outside the skin after initial implantation. This procedure uses an external remote controller in the outpatient department every three months.

Surgical treatment

Spinal fusion surgery

Spinal fusion surgery is recommended to correct a curve or stop it from progressing when the patient is still growing and has a curve that is greater than 50 degrees. Rods and screws are attached to the curved part of the backbone and the spine is straightened. Small pieces of bone graft are then put over the spine. This will grow together with the spinal bone, fusing it into the proper position. A spinal fusion helps prevent progression to severe deformity.